Milk is familiar to each of us from early childhood. But in Lately many are forced to give up healthy drink. Why? The reason lies in the increasing incidence of severe allergic reactions. What is a milk allergy? How and with what is it treated? You can find answers in this article.

Milk is tasty, healthy, energizing during the day and relaxing at night. And everything would be fine, but only the number of allergy sufferers who cannot tolerate even a small amount of this drink is increasing every year. How do you know if you have a milk allergy? What symptoms are typical for her? Is it possible to get rid of this problem? That is what we will be talking about today.

What is a milk allergy?

Milk allergy is a fairly common type. food intolerance, in which the human body reacts sharply to one of the 25 milk proteins. In most cases, allergies are caused by several proteins at once. But sometimes a single protein causes an allergy. The most common allergens are casein, lipoprotein, beta-lactoglobulin and alpha-lactalbumin. True milk intolerance is often confused with lactose intolerance, an inherited deficiency of lactase, which is responsible for the breakdown of milk sugar.

It is worth noting that in 90% of cases, an allergy occurs only to cow's milk, while goat's and sheep's do not cause any negative reactions. It depends on the individual characteristics person.

If we talk about mother's milk, then the situation is ambiguous. By itself, it is hypoallergenic, but if a nursing mother drinks cow's milk, then some of the proteins can enter the baby's body and lead to serious problems with health.

Milk allergy: symptoms

Milk intolerance manifests itself just like any other food allergy. The main symptoms of this allergy include:

1. Violations at work gastrointestinal tract:

• Vomit;
• Diarrhea;
• Constipation;
• Stomach ache;
• Flatulence;
• Cramps in the stomach;
• Heartburn;
• Nausea.

2. Skin reactions:

• Hives;
• Angioedema;
• Atopic dermatitis;
• The appearance of eczema;
• Redness of the skin.
• Itching in the throat and mouth;
• Mucous edema.

3. Other symptoms:

• Runny nose;
• Wheezing in the throat;
• Labored breathing;
• An attack of bronchial asthma;
• Anaphylactic shock.

If we talk about young children, then a few more should be added to the above signs:

• Change in baby's behavior. Children suffering from milk allergy cry often and for a long time;
• Weight loss. Slight weight gain or complete absence also indicate a serious allergic disorder;
• Frequent colic;
• Loss of appetite.
• Dehydration of the body.

Symptoms of "milk" allergies are individual. Someone manages with a slight skin reaction, and someone can become ill even from a small amount of milk they drink.

As for the time frame, an allergy can manifest itself both after 2-3 hours, and several days after eating the allergen.

Milk allergy: treatment

Treatment of allergy to milk proteins should begin with the exclusion of any human contact with the allergen. Next, you need to take the following steps:

Step 1: Take any antihistamine:

• Cetrin;
• Telfas;
• Zyrtec;
• Feksadin;
• Parlazin;
• Loratadine;
• Claritin;
• Erius;
• Fenistil - drops or emulsion;
• Tavegil;
• Diazolin;
• Diphenhydramine;
• Suprastin;
• Fexofast.

Step 2. To remove skin symptoms use the following creams and ointments:

• Eplan;
• Panthenol;
• Bepanthen;
• Korneregel;
• Skin Cap;
• Exoderil;
• Gistan;
• Radeville;
• Fenistil-gel;
• Celestoderm;
• Advantan;
• Flucinar.

Step 3. Take the sorbent:

• Activated carbon;
• Enterosgel;
• Polysorb;
• Liferan.

Step 5. Stick to a strict diet. This paragraph means the following:

1. Read product labels carefully. Very often, milk is referred to by the following "names":

• whey protein or powder;
• Casein;
• Albumen;
• Nougat;
• milk protein;
• Renin;
• Caseinate;
• Cream Frache;
• Lactose;
• Lactic acid;
• Lactalbumin;
• Sour cream;
• Butter;
• Ice cream;
• Powdered or whole milk;
• Cream;
• Margarine;
• Mayonnaise;
• Yogurt;
• Cheese powder;
• yogurt powder;
• Cheese;
• Serum;
• Oil flavors.

2. Replace cow's milk with goat's or sheep's.

3. If the milk of absolutely all artiodactyls causes allergies, switch to products of plant origin. These include:

• Soy milk;
• rice milk;
• oat milk;
• Almond milk;
• Coconut milk.

4. Avoid foods that contain the allergen:

• Condensed milk;
• Cream for coffee;
• Creams;
• Sour cream;
• Butter;
• Processed cheese;
• Cottage cheese - regular and pressed;
• Serum;
• Chocolate;
• crackers;
• Biscuit;
• Pudding;
• Dry breakfasts;
• Margarine;
• Ice cream;
• Bread;
• Yogurt;
• hard cheese;
• Sauces;
• Kefir;
• sausages;
• Sausages;
• Pasta;
• Beer - it contains lactose;
• Food cooked in oil;
• Dry mashed potatoes;
• soup mixes;
• Canned and dry broths.

5. In order to avoid calcium deficiency caused by the rejection of milk and food, which it is part of, enter into your diet the following products:

• Broccoli;
• Halva;
• Spinach;
• Whole grain cereals;
• Eggs;
• oranges;
• legumes;
• Rye bread;
• Almond;
• Nuts;
• Any meat other than veal;
• Shrimps;
• Greenery;
• oysters;
• canned salmon;
• Sardines.

You can also take over-the-counter calcium supplements.

6. If an allergic reaction occurs in babies, be sure to change the milk formula to non-dairy or soy. But first, consult with your allergist observing you.

When should you see a doctor?

There are a number of cases where home treatment is not enough. Be sure to call a doctor if there is a suspicion of a "milk" allergy in a small child. The same should be done if the reaction is very acute. This is evidenced by the following indicators:

1. Frequent vomiting and diarrhea are dangerous due to dehydration;
2. Swelling of the larynx and oral cavity, pressure drops, suffocation - the first signs of anaphylactic shock;
3. Seizures and loss of consciousness.

An allergy to milk may disappear after some time, or it may remain for the rest of your life. Fortunately, modern food industry provides a sufficient number of milk substitutes that allow allergy sufferers to eat fully and varied.

On salicylic, ascorbic, and also on folic acids. We all know that almost every food we eat contains useful material, vitamins, and acids. To prevent unwanted symptoms, you should always have antihistamines with you.

Allergic reaction that occurs when taking folic acid

Allergy to folic acid, or vitamin B9, often leads to asthmatic diseases, such skin reaction like eczema or dermatitis. An allergy to folic acid, the symptoms of which include a severe rash and a rash that can spread throughout the body. In order to get rid of the symptoms, it is enough to simply eliminate foods containing folic acid from your diet: green salad, mint, beef, salmon, etc.

What causes an allergy to ascorbic acid?

Allergy to ascorbic acid is a fairly common occurrence. Ascorbic acid is found in all citrus fruits, pineapples, and is also added to many drinks. Allergy to ascorbic acid, the symptoms of which are itching skin, as well as redness and peeling of some parts of the body, is quite harmless, but brings some discomfort to a person. Therefore, if you have this type of allergic reaction, it is best to eliminate foods that contain this acid from your diet.

In this connection, an allergy to nicotinic acid may appear

Nicotinic acid is also called hyaluric acid. Allergy to nicotinic acid, the symptoms of which are swelling of the affected parts of the body, itching, and blistering, appears with abuse fish oil. It is important to note that in an acute reaction, anaphylactic shock may even occur. Therefore, if you are allergic to nicotinic acid, you must exclude all foods that contain vitamin B3.

Allergy to hyaluronic acid: symptoms, causes, and methods to prevent an allergic reaction

As a rule, hyaluronic acid enters the body with “beauty injections”. Many women actively use this procedure, not even suspecting that the body may not perceive it. Allergy to hyaluronic acid, the symptoms of which are a burning sensation, severe swelling, can not only harm your beauty, but also health. Therefore, you should be careful about all kinds of injections, and carry them out only after consulting with an experienced allergist. Allergy to hyaluronic acid is easily eliminated with complete isolation of the allergen.

Allergies that occur when in contact with lactic acid, and how to deal with it

Lactic acid is usually formed during the fermentation of milk. It is found in foods such as cheese, kefir, yogurt, etc. Therefore, people who are allergic to lactic acid should avoid these products. For timely treatment the best option would be to go to the doctor who will prescribe special diet, it must be adhered to throughout life. Lactic acid allergy, which has symptoms similar to other allergic reactions, is a harmless disease and does not lead to complications.

Allergic reaction to acetylsalicylic acid - what to do?

An allergy to acetylsalicylic acid or aspirin can lead to bronchial asthma, as well as the development of a disease such as urticaria. As a rule, aspirin is contained in drugs that are used to eliminate pain syndromes (analgesics), so you should be especially careful with such drugs, as well as antipyretic drugs. Allergy to acetylsalicylic acid, the symptoms of which are divided into several types, is quite unpleasant. It can be rhinosinusitis, asthma, cytopenia, pneumonitis.

Allergy that occurs when consuming citric acid

Everyone knows lemons and how sour they are. They are often used in the preparation of salads, and also added to tea. However, when overuse lemons can be allergic to citric acid. It should be noted that citric acid is also found in all citrus fruits. Unfortunately, an allergy to citric acid, the symptoms of which can be relieved by antihistamines, is not treated. Often after eating foods that contain this acid, there are disorders of the gastrointestinal tract - nausea, vomiting, diarrhea. In order to prevent these unpleasant syndromes, it is necessary to abandon citrus fruits.

Allergy to salicylic acid: causes

Usually, an allergy to salicylic acid occurs with the use of anti-inflammatory drugs. Symptoms:, itching, as well possible redness skin, disappears almost immediately, as soon as a person refuses products that contain salicylic acid.

Allergy to boric acid, symptoms and description

Allergy to boric acid, the symptoms of which can be severe nausea, a rash on the skin, as well as a rash, is quite rare. If you are allergic to boric acid, you must exclude this substance, as it is contraindicated for you.

Allergic reactions that occur upon contact with acetic acid

First of all, if you have but allergic to acetic acid, is contraindicated, because its enzymes, entering the body, turn into acetic acid and can cause severe reddening of the skin (spots), itching, and an increase in body temperature. Allergy to acetic acid, the symptoms of which disappear about an hour after drinking alcohol and do not carry any complications.

One of the types of negative reactions of the immune system is an allergy to milk in a child. Young children are more susceptible to the disease. This is a serious disease that can cause allergies in children older than 1 year to the consumption of cow's and goat's milk.

Appeals to doctors about this have become more frequent. This disease is diagnosed in 5% of children, since milk protein is a fairly common food allergen.

It is necessary to distinguish between an allergy to cow protein and its intolerance. In the first case, the body sees it as a foreign element and begins to defend itself, and in the second case, the problem is the poor digestibility of dairy products. The reaction in children to cow's milk protein is manifested in skin rashes on the face, disorders of the digestive and respiratory systems.

Skin symptoms:

• peeling of the skin;
• the appearance of a milk scab, eczema;
• feeling of itching;
• rash (urticaria);
• large red spots on the surfaces of the skin of the face, chest -;
• rapidly increasing swelling in the neck and head area - Quincke's edema.

With regard to digestive disorders, an allergy to cow's milk in children is manifested by:

• intestinal disorders - colic, constipation, diarrhea, flatulence;
• pain in the abdomen;
• nausea, vomiting.

The respiratory tract responds to the effects of bovine protein:

• nasal congestion;
• cough;
• labored, wheezing breathing;
• runny nose;
• wheezing.

All these reactions occur immediately when the protein enters the child's body and appear both individually and in combination. A delayed reaction may be diarrhea or itching of the skin, which will appear after a few days.

Attention should be paid to such anxiety symptoms, like Quincke's edema and a rash, the spread of which is rapid. Such conditions are life threatening and require urgent medical attention.

Another factor that causes parents to fear for the health and life of the baby is the presence of a barking cough, dry wheezing, and wheezing. Need medical help.

An allergy to milk in a child manifests itself at an early age, often before the age of one. With proper treatment, it disappears by about 5 years, and only occasionally persists for life.

If the disease does not go away by this age, problems with the transition of allergies to other forms of the disease, especially dangerous ones, are not ruled out.

Allergy to goat milk in children is much less common. Its features include:

• rash, skin eczema;
• inflammation of the eyes, nasal mucosa;
• itching in the mouth (rare);
• hard breath.

The specific taste and smell that goat's milk has causes rejection in many children; it is difficult to feed food based on it. Experts believe that the body feels that this product can become a potential allergen, so you should not feed your child with food containing such milk if he refuses. Cause of goat milk allergy hereditary factor, weak immunity of the child.

Diagnostics

The correct diagnosis of allergy to cow's or goat's milk can only be carried out by a complex method. The clinical picture of the disease is compiled by a pediatrician after a visual examination of the child. Attention is drawn to the presence in the anamnesis of parents of such an allergy.

After a full study, in assessing the external manifestations of allergies, the presence of concomitant diseases ( chronic problems with intestines, atopic dermatitis, anemia, etc.), the doctor prescribes a series of tests to the patient - urine, feces, blood, prick test skin tests, which will help to exclude similar diseases. Of particular importance is a blood test for allergy tests, which allows to detect immunoglobulin E to cow's milk protein.

Often, milk allergy is diagnosed by exclusion, when dairy products are temporarily removed from the child's menu. If, after the start of their use, the symptoms of this disease reappear, then the test is considered positive, indicating the presence of an allergy to milk protein.

Treatment

The treatment consists primarily in the use of sorbents that remove allergens. They circulate throughout the body, causing an allergic reaction in any of the organs. Treatment depends on where the negative reaction occurs.

Gastrointestinal system

Children after a year often complain of short-term, but recurring pain in the navel area if they continue to be fed dairy products. Worried about bowel problems. The lack of bifidobacteria leads to. Treatment of all problems of the gastrointestinal tract is carried out with the help of probiotics. Doctors recommend temporarily replacing milk in the children's diet with dairy products.

Skin lesions

• Milk scab (gneiss) . The appearance of lesions in the form of a crust on the head indicates the beginning of problems in the child's body. Treated with herbal or vaseline oil, lubricating the head, followed by combing out with a comb.
• Atopic dermatitis. It is a plaque covered with scales. Formed with inside elbows, below the knees. The child experiences severe itching, the rash gets wet periodically. Treatment with moisturizing ointments, creams with zinc. In case of exacerbation, they are prescribed antihistamines, enzymes.
• Hives. Acts as an allergic reaction. Blisters appear, causing itching and a desire to itch. They look like nettle burn. Treated with antihistamines.
• Quincke's edema. Acute reaction to milk intake. The mucous membranes of the mouth, eyes, lips swell, there is no itching. There is a high probability of asphyxia with laryngeal edema. Emergency medical assistance is needed, the use of hormonal drugs.

Respiratory system

With milk allergy, the respiratory organs are affected less frequently. May appear allergic rhinitis. Dangerous development of laryngospasm, which is indicated by wheezing, shortness of breath. The child may suffocate if not given immediate medical attention. Sometimes allergies lead to bronchial asthma, the treatment of which will be prescribed by a specialist.

In any case, the reaction to cow's milk protein should be eliminated by professional doctors, self-medication is unacceptable.

Nutrition Features

Although in most children the allergy to dairy products disappears by the age of 3-5 years with the development of the immune and enzymatic systems, some have to follow a diet before all manifestations of the disease disappear. Recommendations on how to feed a sick child and what should be excluded from his diet are given by a specialist.

Only a doctor can determine the allergen, given its hidden presence in the composition of other products and the presence cross allergy. According to medical statistics, children with an allergy to cow protein and dairy products in 90% of cases have the same reaction to goat milk.

There are vegetable types of milk - soy, rice, oatmeal, which can replace milk from animals. Such a diet will make the children's menu more varied and useful. If there is no allergy to goat's milk, then you can replace the usual cow's milk with it, give your child water or feed it with cereals prepared on its basis.

Goat milk is also added to tea for better absorption. It is recommended to stick to a diet for about 1-2 years, during which the formation of the immune system takes place, and the child simply “outgrows” this type of allergy.

A good substitute for any milk can be fermented milk products that do not cause allergies. In the process of fermentation, the protein will break down into simple amino acids, which are much better digested, leaving virtually no allergens.

The child can be given kefir, yogurt, which can be based on cow or goat milk. They usually do not cause gastrointestinal upset. Selection proper diet guaranteed to improve the patient's condition and the outcome of the disease.

Skin care during an exacerbation

The main concern with milk allergy is skin damage, especially atopic dermatitis, in which moisture is lost in it, the skin becomes dry with microcracks, itching, and its protective properties are lost. That's why it's important to ensure proper care behind the skin.

There is a misconception that children should not be bathed during an exacerbation of allergies. On the contrary, they require daily bathing to cleanse and moisturize the skin. It is better to bathe in a bath for at least 20 minutes, so that the stratum corneum of the skin has time to be saturated with water.

It should be settled, warm, about 35 ° C. You can not use washcloths, and after bathing, do not wipe the body strongly, just get it slightly wet. For such patients, special detergents with anti-inflammatory action should be purchased.

An important aspect of skin care is its moisturizing to restore damaged protective properties. The use of modern atopic skin care products helps to slightly compensate for the defects of the epidermis.

Under the direction of pediatrician you can choose the most effective means that will suppress allergic inflammation. Skin treatment will require long periods of time, the attention of parents, the active help of doctors.

Causes of milk allergy

The main problem of allergies is the immaturity of the gastrointestinal tract, the weakness of the child's immune system. In most cases, the reaction is caused by cow's milk, occasionally - goat's, sheep's. The main cause of an allergy to milk is the presence of casein in it - a protein that settles in the form of a curd formation when milk coagulates. The immune system interprets casein as foreign body, starting to produce antibodies, which leads to an allergy to the protein.

A direct connection between childhood milk allergy and a history of parental negative reaction to protein has also been established. If one of the parents had this kind of allergy in childhood, then the probability of a problem in a child will be 30%. Both parents with this disease increase the chance of a baby having an overreaction to milk by up to 80%.

But an allergy can be in a child with healthy parents. The disease is called malnutrition with weak immunity. Negative influence on the children's body may have a bad environment in the place where the child lives. Allergies are sometimes provoked by the presence of antibiotics in the milk of a pet.

Sour-milk products - various curds, kefir, cheese rarely cause allergies. Its cause is individual intolerance, weakened immunity. Most often, it manifests itself due to additives in these products. Be careful when purchasing them for baby food, supplements can be aggressive.

What diseases can be confused with milk allergy

Most often, cow's milk allergy is confused with lactase deficiency, which is birth defect enzymatic digestive system. It is characterized by insufficient production in the intestines of the enzyme responsible for the breakdown of milk sugar.

A child with such a problem creates intolerance to any milk. Both diseases have similar symptoms, manifested in diarrhea, colic, flatulence.

You can distinguish them by conducting a test for lactase deficiency, which for a child of the age of one year consists in excluding dairy products from the menu. If there are no symptoms in the coming days, then this means that they are not allergic to protein.

Gastrointestinal allergies to milk often resemble reactions to other foods or intestinal infections. With severe symptoms of diseases of the upper respiratory systems (runny nose, bronchitis), a milk allergy in a child can also be perceived as a consequence of these diseases, so it is important to distinguish them.

An allergy to any kind of milk, subject to a diet, most often ends at an early age - by the age of 5, which is explained by the development of the child's digestive system by this age. Only in 15% of children, often with other allergic reactions, the disease persists.

Scientists conducted an experiment related to milk allergy. Giving the child an increasing portion of milk every day, they noticed a decrease in skin manifestations. And they concluded that such training of the immune system will gradually get rid of the disease.

The difference between milk allergy and lactose intolerance

Answers

Milk- This is a fairly nutritious product for the body, which contains fats, proteins, vitamins, minerals, calcium. But there are times when the drink has a detrimental effect on the children's body.

According to statistics, the number of children under 1 year old,

suffering from allergies to dairy products is about 10%.

Allergy- this is an atypical response to the appearance in the body of a foreign protein-antigen. Cow's milk contains 25 of these antigens. Among them, the most active in terms of influence on the body are casein, alpha-lactoglobulin, serum albumin, beta-lactoglobulin.

The structure of a protein resembles a chain in which the links are amino acids. When it enters the stomach and intestines, the influence of enzymes destroys the chain, and it breaks up into separate parts, which are individually absorbed by the body without problems.

The immature digestive system of young children may not have some enzymes, so when the protein chain is split, the destruction does not affect individual groups links. The resulting complex of links cannot be normally absorbed by the intestines and provokes the response of the body's immune system, which manifests itself as an allergy.

Pseudo-allergy to milk - the body has a sufficient set of enzymes to break down the protein structure, but the amount of milk drunk is so large that the body cannot cope with it immediately. An excess amount of protein from a product in an organism with normal functionality also leads to the development of allergies. In this case, the allergy does not appear due to the nature of the product, but through its quantity.

A true allergy to dairy products - develops even with a small amount of milk drunk (and even obtaining cow's milk protein through breast milk), but through an immature enzymatic system, the body cannot cope with the protein load.

There is an allergy to the protein contained in cow's milk and intolerance to milk protein. Intolerance is the occurrence of difficulties with the digestion of milk, the immune system is not involved in this process, and allergy is the response of the body's immune system to a foreign protein.

Causes of milk allergy

Some sources see the cause of allergies in an inadequate reaction of the human immune system to milk protein, others consider lactose (milk sugar) to be the cause. At the same time, both will be right, since an allergic reaction when eating dairy products can be triggered by both lactose and milk protein.

Real photos of allergies to protein, milk in children

The body of a newborn can perceive only mother's milk without load, any mixture is rough food for the baby's intestines. The mucous membrane of the digestive system of infants is not mature, not protected by the inherent microflora, and therefore loose, easily passable for allergens. The walls of the intestines and stomach of a child acquire the ability to prevent the introduction of pathogenic agents only by the age of 2 years. In cases where:

The mother of the child is prone to the development of allergic reactions;

There was a pathological course of pregnancy - preeclampsia, the threat of interruption, fetal hypoxia, stress;

Pregnancy was burdened by adverse environmental conditions - work in hazardous industries, living in a metropolis or an industrial city.

The risk of an allergic reaction in a child increases. That's why important factors to reduce the risk of allergies are: the course of pregnancy, the age and health of the mother, the presence bad habits parents, lifestyle, diet, ecology, heredity.

Manifestation of milk allergy

Given that the allergen constantly circulates in the blood, an allergic reaction can affect any system and organs of the body. Allergy to cow's milk protein can be aggravated by poor environmental conditions, severe infectious diseases, colds, and stress.

Gastrointestinal Disorders

For children under 1 year old, a characteristic feature will be loose stools, caused by the fact that the digestive organs cannot cope with their duties:

curdled milk, undigested food residues will be contained in the feces;

for young children, the appearance of frequent and profuse regurgitation is characteristic, in slightly older babies - vomiting.

The immune system, with the help of antibodies, attacks milk proteins, while along with antigens, the intestinal mucosa is damaged.

Therefore, feces may contain red blood cells, which are visible to the naked eye as blood streaks or individually in a special analysis. Such signs indicate severe course allergies.

Damage to the intestinal mucosa is accompanied by pain in the abdomen, so young children become capricious, restless, cry a lot. This condition must be differentiated from colic. It is worth noting that the appearance of a reaction is possible only when a fermented milk mixture based on cow's milk or cow's milk itself enters the body. Breast milk cannot cause an allergic reaction (only in rare cases), but the foods that make up the mother's diet can.

With the constant intake of milk by children older than 1 year, the pain passes into the chronic stage. It is localized near the navel and has a short-term character. There may also be symptoms of colitis, intestinal motility disorders, intestinal colic.

Any allergic reaction of the body is accompanied by the release of histamine, which leads to an increase in the amount of hydrochloric acid in the stomach. This explains the occurrence of pain in the child in the epigastric region.

An allergy to milk that does not go away and exists for a long time can cause a secondary enzyme deficiency in a child. The production of pancreatic enzymes decreases, the absorption of cereal gluten and lactose worsens.

The number of bifidobacteria characteristic of the intestine decreases, pathogenic microbes multiply in their place: enterococci, E. coli. This development of events has an adverse effect on the health and well-being of the child.

Skin lesions

The skin is the second organ that is severely affected by and food allergies. The most common symptoms of cow's milk allergy are:

• milk scab

This is the first signal that a failure has occurred in the child's body. Most often, milk scab occurs in infants who are bottle-fed. Such a symptom may also appear in a baby, but the cause of such a symptom will not be cow's milk protein, but a product that is included in the mother's diet. Gneiss, also known as a milk scab, appears on the head of a child in the form of a crust. Such a crust should be lubricated vegetable oil or petroleum jelly, and after softening - comb out with a comb.

• baby eczema

In most cases, it appears on the cheeks, but it can affect any part of the baby's body. First, bubbles develop, which go into a state of erosion, producing clear liquid(exudate). Subsequently, the wounds begin to heal and turn into crusts and scales. The symptom occurs in children under 6 months of age.

• Limited atopic dermatitis

The symptom manifests itself on the elbows and under the knees in the form of plaques that are covered with scales. The rash is very itchy and may occasionally get wet.

This is one of the acute allergic reactions of the body caused by the intake of a dairy product. The manifestation of a symptom is characterized by the appearance of edema in places with developed subcutaneous tissue- genitals, eyelids, lips, oral mucosa, while itching of the skin is absent. The appearance of Quincke's edema on the mucous membrane of the larynx can lead to asphyxia, that is, suffocation of the child. This condition is considered an emergency and requires emergency care and the introduction of corticosteroid drugs.

• Hives

Another type of acute allergic reaction of the body to dairy products, however, it is less common and has less dangerous consequences than angioedema. A characteristic sign of urticaria are blisters with redness around, which in their shape resemble a nettle burn (hence the name), while they are very itchy and itchy. When such a reaction develops, mandatory application antihistamines.

Respiratory damage

It occurs infrequently and is manifested by the reaction of the respiratory system:

allergic rhinitis, sneezing;

Difficulty breathing and the occurrence of wheezing, threatening the development of laryngospasm. This is a serious condition, which consists in swelling of the laryngeal ligaments. In this case, there is no way to inhale, and the child may suffocate.

Bronchial asthma - one of the triggers for the development of the disease is an allergy to the protein contained in cow's milk.

Steps to Determine if You Have a Milk Allergy

The doctor collects anamnesis- Availability atopic dermatitis, anemia, chronic diarrhea, allergic manifestations, poor weight gain.

Lab tests- to exclude other diseases and allergies to other food products from cow's milk protein allergy and milk intolerance, the doctor will write out a referral for testing: blood for allergens, skin prick test, feces for dysbacteriosis, coprograms.

The symptoms of lactase deficiency can be very similar to those of a milk protein allergy: diarrhea, regurgitation, bloating, and colic. The child has frothy, watery stools, in some cases green, with a frequency of more than 8-10 times a day. There is also a combination of these two pathologies.

With lactase deficiency, it is the lack of the enzyme - lactase, that is the cause of the development of these symptoms. The function of the enzyme involves the breakdown of the disaccharide lactose into simple carbohydrates that are absorbed in the intestine. With a lack of enzyme, unsplit lactase begins to accumulate in the intestine and leads to an influx of fluid and an increase in osmotic pressure in it. Thus, flatulence and diarrhea appear, as well as other symptoms.

Test for lactase deficiency

In order to differentiate lactase deficiency from an allergic reaction to bovine protein, an examination is required. simple test, which consists in following a lactose-free diet for several days:

• with artificial feeding, the child is transferred to a lactose-free mixture;
• if the mother is breastfeeding breast milk, then she must follow a lactose-free diet;
• if the child is older, they stop giving him dairy products and milk.

If the symptoms disappear in the near future, this confirms that the child has a lactose deficiency. The fact is that for the disappearance of symptoms in the presence of an allergy to protein, this time will not be enough.

In addition, allergy to cow's milk protein is more common in babies and in most cases disappears by the age of three. In turn, lactase deficiency is not only from birth, but also acquired. In such cases, it occurs against the background of a child transferred rotavirus infection or giardiasis of the intestine. In such cases, lactase deficiency is eliminated by diet.

Algorithm of actions for milk allergy in infants

Mother's milk is the ideal food for a baby. It contains in its composition unique enzymes that, once in the baby's body, are activated in the stomach and help to easily digest and assimilate food. Therefore, pediatricians recommend trying to breastfeed your baby for as long as possible, while observing a hypoallergenic diet.

All products containing milk itself and its traces should be excluded: dry cream and milk powder, store-bought pastries, butter, dry soups, chocolate, ice cream, condensed milk, cream.

If a breastfed baby has signs of an allergy to milk, it is necessary to change the diet of the nursing mother. Different sources allow the mother to consume from 100 ml to 400 ml of milk per day, however, if the child is allergic to milk, milk should be completely excluded, if the allergy is not pronounced, you can try replacing milk with cottage cheese, yogurt, fermented baked milk, kefir. The child's condition should improve in 2-4 weeks, if this does not happen and there is 100% confirmation of milk allergy, the child should be switched to a formula with deep protein hydrolysis.

If a baby is allergic to cow's milk, an allergic reaction to goat's milk protein can also be observed. In the case of a severe allergy to milk protein in a baby, nuts, fish, and eggs should also be excluded from the diet of a nursing mother.

If a child has a milk intolerance, this is not an excuse to exclude fermented milk products from his diet. Complementary feeding of a child with fermented milk products must be carefully introduced from the age of 7 months, it is better to start with home-made yogurt (from cow or goat milk) or kefir. From 9-10 months, you can start introducing cottage cheese into complementary foods, from 1 year - fish, eggs.

Fermented milk products should not provoke an allergic reaction because during the processing they undergo hydrolysis, fermentation causes the milk protein to break down into amino acids that are better absorbed by the body and contain a minimum concentration of the allergen.

If a child has milk intolerance, fermented milk products should not provoke hives, bloating, and gastrointestinal disorders. But these products must be used with caution.

Cottage cheese for a child at home

The use of store-bought cottage cheese by a child is allowed only if it is labeled “for children”, but such a product can also cause allergies (through the presence of additives), so making the cottage cheese on your own is an ideal solution. To do this, add 1 tablespoon of sour cream to a glass of milk and let the mixture brew at room temperature, then pour the sour milk into a saucepan and heat over low heat until the whey separates. After that, the resulting curd is collected and squeezed with gauze to separate excess liquid. It turns out a ready-to-eat product that needs to be stored in the refrigerator for no more than one day.

Algorithm of actions for an allergy to milk in an artificial person

Modern mixtures for artificial feeding are made on the basis of cow's milk, so the first step will be to change the mixture to an analogue, which is made on the basis of goat's milk, if that does not help, the mixture is changed to a hydrolyzate. After 6 months, you can try to switch to the usual formula, if the symptoms begin to return, you should return to the hydrolyzate formula and shift the introduction of complementary foods with dairy products in time by six months.

Mixtures "Goat" and "Nanny" are made on the basis of goat's milk. They are much better tolerated by children, but they are more expensive, and do not forget that an allergic reaction to goat milk protein is also possible.

Hydrolyzate mixtures are easily absorbed by the child's body and in most cases do not contain lactose. The proteins in this diet are broken down into dipeptides.

On the Russian market, such mixtures are represented by NutrilonPepti TSC, Nutrilak peptidi SCT, Pregestimil, Alfare, Frisopep, Pepticate, Frisopep AS. Foreign analogues are used in severe cases of allergy to cow's milk protein, these are: "Critacare", "Vital", "Vivonex".

To prevent allergies in a child with increased risk its occurrence, mixtures with partial protein hydrolysis are used: “NAN hypoallergenic 1 and hypoallergenic 2”, “Nutrilong hypoallergenic 1 and hypoallergenic 2”.

With milk intolerance, as well as for the prevention of allergies: Humana GA1 and GA2, Nutrilak GA, Hipp GA1 and GA2.

Allergy to milk in children older than a year

With the final formation of the enzymatic and immune systems, the manifestation of allergies stops. If the rash or other allergic reactions have not completely disappeared, it is necessary to completely eliminate the use of milk. With a strong need, milk can be replaced with a vegetable analogue:

rice milk- to obtain such milk, it is necessary to grind the cooked rice in a blender, and then filter the resulting mass.

oat milk- is a rich source of vitamins and minerals. Oats are washed directly in the husk, poured with water, and then boiled over low heat for more than an hour. The resulting product is filtered.

Soy milk- a product rich in minerals and proteins, which is obtained from soybeans. To prepare such milk at home, it is necessary to soak the beans, then boil them, grind to a puree consistency and strain.

When following a lactase-free diet, these foods will help diversify your child's diet. Older children can be tried to switch to goat milk products.

Forecast

Every year the number of children suffering from allergies increases. Modern diagnostic capabilities make it possible to more accurately and easily determine the cause of allergies than ten years ago. Knowing the exact cause of allergies, it is easier to deal with it. According to statistics, about 40-50% of children cope with allergies in the first year of life, and 80-90% get better by the age of 5, and only in rare cases, allergies persist for life. In such cases, fermented milk products can replace milk.

Recently, American scientists conducted an experiment in which children with allergies increased the amount of milk consumed every day, this led to a decrease in the manifestations of allergies on the skin over time, and the immune system began to react less actively to the allergen.

The result of the experiment confirmed the theory that drinking milk trains the child's immunity, allowing, in the end, to cope with allergies on their own. Our medicine does not yet support this point of view.

And what will Dr. Komarovsky say about this problem? Watching video

B-lymphocytes carry out a different type of immunity. If necessary, they transform into plasma cells that do not attack the allergen on their own, but produce antibodies of various classes that destroy it on their own or with the help of the complement system and T-lymphocytes. Thus, humoral or extracellular immunity is carried out.

Stage of biochemical reactions

The stage of biochemical reactions develops upon repeated contact of the allergen with the human immune system. T-lymphocytes and antibodies actively migrate to the site of contact and begin to destroy the antigen. Along the way, a number of substances are released, which lead to the appearance of classic signs of allergy, such as rash, itching, temperature, shortness of breath, etc. These substances, first of all, include histamine, serotonin and bradykinin. These substances, otherwise called inflammatory mediators, are produced and stored in special mast cells and released under the influence of the command of any immune cell.

Being released into the tissue, they dilate the vessels in the affected area, thus slowing down the blood flow and improving the conditions for the deposition of lymphocytes on the vascular wall. Settling on vascular wall lymphocytes penetrate through it into the focus of an allergic reaction and come to grips with the allergen. Slowing blood circulation has another goal - limiting the spread of the allergen through the bloodstream throughout the body. This mechanism is extremely important, because with its inferiority, anaphylactic reactions develop, which pose a threat to life.

Together with histamine, serotonin and bradykinin, other inflammatory mediators are included in the allergic process, which indirectly or directly affect the course of the allergic process. These include various interleukins, cytokines, leukotrienes, neurotransmitters, tumor necrosis factor, and many other factors. Together, they provide an increase in body temperature, itching and pain reaction.

Stage of clinical manifestations

This stage is characterized by the response of tissues to the release of biologically active substances. Since milk is one of the most powerful allergens, the range of the body's response will be large - from simple urticaria to anaphylactic shock. The severity of clinical manifestations directly depends on the dose of the allergen, the rate of its spread throughout the body, the degree of sensitivity of the immune system to it, and the state of the immune system itself. Also, the reaction of the body may differ in terms of manifestation. So, there are four main types of allergic reactions. The first, second and third types proceed as an immediate hypersensitivity reaction. In this case, the count goes for seconds, minutes, less often for hours. The fourth type of allergic reactions proceeds as a delayed-type hypersensitivity reaction. With this type, an allergic reaction develops within hours or even days.

Possible manifestations of a milk allergy are:

• allergic rhinitis;
• headache;
• skin manifestations;
• bronchospasm;
• anaphylactic shock.

Risk Factors Contributing to the Development of Milk Allergy

An allergy to breast milk can develop in a newborn baby, and an adult can develop an allergy to the milk of mammals. The mechanism of allergization of the body is almost identical in both cases, but the factors leading to allergies are different. That is why risk factors are conditionally divided into congenital and acquired, and acquired, in turn, into those acquired in the first year of life and after the first year.

Risk factors leading to congenital milk allergy:

• hereditary predisposition;
• the use by the mother during pregnancy of highly allergenic foods;
• excessive consumption of milk during pregnancy;
• intensive drug therapy during toxicosis;
• insufficiency of secretory immunity;
• features of the immune response;
• changes in the innate balance of pro-inflammatory and anti-inflammatory cytokines;
• hypersensitivity peripheral tissues to allergy mediators;
• violation of the enzymatic activity of phagocytes;
• congenital violation of the processes of deactivation of biologically active substances.

hereditary predisposition

Some nationalities and ethnic groups have a genetically programmed deficiency of certain enzymes that digest milk proteins. Representatives of such a population are some nomadic tribes of the northern regions of Siberia. Drinking milk causes severe diarrhea and abdominal pain in them, and also makes the body more sensitive to this product. With the repeated use of milk in these people, allergy symptoms are added to the usual symptoms of intolerance, which, as indicated earlier, can be very diverse.

Maternal consumption of highly allergenic foods during pregnancy

It is clinically proven that children born to mothers who allowed themselves the use of highly allergenic foods during pregnancy also had an allergy to certain substances, including milk. These foods include cow's milk, eggs, fish, peanuts, soybeans, citrus fruits, strawberries, strawberries, black currants, hazelnuts, crustaceans and even wheat. This does not mean that these products should be completely eliminated from the diet, but they should be used extremely sparingly, knowing the possible consequences. The reason is that in utero the fetus receives nutrients from the mother's body through the umbilical cord. Those nutrients that circulate in the mother's blood can interfere with the fetus's developing immune system. The result of such malfunctions, as a rule, is a violation of the body's immune tolerance to certain substances.

Excess milk consumption during pregnancy

Milk is a high-calorie and valuable product in terms of protein composition. However, with its excessive use, part of the milk proteins reaches the intestines in a form insufficiently prepared for absorption due to the limited resource of its digesting enzymes. As a result, some of the large, undigested milk proteins are absorbed unchanged. Since these proteins are unknown to the body, the cells of the mother's immune system absorb it, and with the subsequent ingestion of milk, even in normal amount it causes allergies in both mother and child due to the close interaction of the immune systems of the two organisms during pregnancy.

Intensive drug therapy during toxicosis of pregnancy

Toxicosis develops as a reaction of the mother's body to the fetus growing in it. It develops when there is an imbalance between factors that support pregnancy and immune system factors that tend to reject the fetus as a foreign body. During toxicosis, millions of chemical reactions occur in the mother's body every second. Many biologically active substances are released into the blood, which, in parallel with their direct effect, significantly change general state mother herself. In such conditions, all systems of her body and the body of the fetus are working for wear and tear.

When layering on this state of any other disease, such as pneumonia, cystitis or sinusitis, it becomes necessary to take such medicines as antibiotics, antipyretic or pain medications. These medicines have a side effect, manifested by the development of cell membrane instability syndrome. The essence of this syndrome is the release of allergy mediators even with the slightest irritation. Since the mother and fetus are closely related, this syndrome will manifest itself in the child and may persist for life. One of its manifestations is an allergic-like reaction to any substance ( milk, strawberries, chocolate, etc.) or a physical factor (), provoking the release of allergy mediators.

Lack of secretory immunity

Many glands of internal and external secretion of the body secrete a secret containing substances that neutralize many potential allergens before they come into contact with the mucous membranes of the body. These substances include lysozyme and class A immunoglobulins. In addition, the mucus itself performs a protective function, since it prevents direct contact of the allergen with the mucous epithelium, while simultaneously increasing the time taken for lysozyme and immunoglobulin A to destroy a substance that can cause allergization of the body. Some people have congenital deficiency protective substances in saliva, lacrimal fluid and the secretion of the cone glands. This leads to the fact that an aggressive substance, which may include milk, freely penetrates into the bloodstream and, upon repeated contact with them, causes the development of an allergic process.

Features of the immune response

The immune system healthy person is distinguished by a clear balance of the number of its certain elements and well-functioning interaction between them. Under the influence of numerous factors, disturbances in the correct intrauterine development of the immune system can occur. Consequently immune cells may turn out to be overly active, the number of antibodies will exceed normal values, and the ratio between their various classes will be disturbed. The above changes will contribute to an increased allergic background, in which any substance, and even more so milk, will cause an allergic reaction.

Altering the innate balance of pro-inflammatory and anti-inflammatory cytokines

Cytokines are substances that regulate the speed and intensity of the inflammatory process in the body. Pro-inflammatory cytokines increase the inflammatory process, while anti-inflammatory cytokines, on the contrary, reduce it. Since the allergic process is a specific inflammation, it is also subject to the influence of cytokines. With certain disorders of embryonic development, there is a shift in the balance towards pro-inflammatory cytokines, leading to the fact that the child is born with increased reactivity. In such a situation, milk, being strong allergen, will provoke sensitization of the body and the development of an allergy to this product in the future.

Hypersensitivity of peripheral tissues to allergic mediators

The main mediators of allergy are histamine, serotonin and bradykinin. When these substances interact with tissues, symptoms characteristic of the inflammatory process develop. When peripheral tissues have high sensitivity to the above mediators, the tissues respond to irritation of normal strength too actively, and the usual inflammation develops into an allergic process.

Violation of the enzymatic activity of phagocytes

Phagocytes are called cells of the macrophage system, located both in the blood and in other tissues of the body, which perform the function of collecting and destroying various substances that have fulfilled their function, fragments of dead cells, even harmful bacteria. One of the functions of phagocytes is the absorption and destruction of allergy mediators. In the case of a slow metabolism of these cells, allergy mediators stay in the tissues for a longer time and, accordingly, have a more pronounced effect. At the same time, the allergic background of the body increases, and milk, being a strong allergen, most likely sensitizes the immune system and, if it enters the body again, will cause an allergic reaction.

Congenital violation of the processes of deactivation of biologically active substances

Biologically active substances released in large quantities into the tissues of the body during a relapse of an allergy should be promptly removed and rendered harmless. These substances include hormones, neurotransmitters, mediators of various phases of the inflammatory process, etc. The neutralization of these substances is carried out by the previously mentioned phagocytes, as well as liver and kidney enzymes. Some of the substances bind to blood proteins and circulate in it in a bound form until the enzymes that neutralize them are released. With insufficient function of neutralizing systems, biologically active substances accumulate and cause an increase in the allergic background.

Risk factors leading to milk allergy in the first year of life:

• failure of a hypoallergenic diet during breastfeeding;
• late attachment to the breast;
• early artificial feeding.

Breaking a hypoallergenic diet while breastfeeding

During pregnancy and especially during lactation, a woman must, without fail, follow a diet that excludes the most allergenic foods. If such a diet is violated, some elements of prohibited foods enter the milk in less than 2 hours after consumption. When such milk enters the underdeveloped gastrointestinal tract of a child, highly allergenic products are absorbed unchanged in the intestine. This is due to the fact that the enzymes that must process them are either not yet present in the intestines, or are present, but in insufficient concentration. As a result, an increased sensitivity of the child's immune system to a particular allergen develops. Cow's milk in the same way can cause an allergy in a child when consumed by his mother, especially if she has the lowest tolerance for milk.

Late attachment to the breast

According to the latest guidelines in obstetrics and gynecology, the newborn should be attached to the mother's breast no later than 2 hours after birth. This measure is intended to shorten the period during which the intestines of the newborn remain empty, or more precisely, not containing mother's milk. Breast milk and especially colostrum a thick, whitish, sticky substance that comes out of the breasts during the first 2 to 3 days of breastfeeding) contain a large number of antibodies that destroy pathogenic microbes that already inhabit the intestines of the newborn. With an increase in this period to 5-6 hours, 70% of newborns develop dysbacteriosis, which is a factor contributing to the appearance of an allergy in a child even to breast milk, despite the fact that it is the most suitable product for his food.

Early artificial feeding

The quality of artificial infant formula has greatly improved today. They contain almost all the components that are in breast milk and even those with which it could be enriched. However, they have one important drawback - the absence of antibodies. It is the antibodies that support the child's immunity against those infections that the mother's body has encountered throughout her life. The mother's milk-borne antibodies protect the baby until its own immunity can protect the body on its own. In other words, as long as the baby is fed with breast milk, he is much better protected from infections than if he were fed the best artificial mixtures that exist today. Accordingly, if there is a risk of infection, there is also a risk of developing allergies, since many infections create conditions for the penetration of potential allergens into the bloodstream.

Risk factors leading to acquired milk allergy after the first year of life:

• pathology of the gastrointestinal tract;
• liver disease;
• helminthic invasion;
• unreasonable intake of immunostimulants;
• aggressive environmental factors;
• acquired hypovitaminosis;
• long-term use of ACE inhibitors.

Pathology of the gastrointestinal tract

As mentioned earlier, the gastrointestinal tract ( gastrointestinal tract) is a kind of barrier that prevents the penetration of the allergen into the body in the form in which it could harm it. Gradual exposure to milk as a potential allergen, first sour, and then alkaline media, various enzymes and intestinal microflora deprives it of antigenic properties and the ability to interact with the immune system.

In the presence of a disease of one of the sections of the digestive system ( gastritis, gastric ulcer, chronic duodenitis, etc.) milk is less carefully processed. Being absorbed into the blood in the form of a large molecule, it is perceived by the body not as a nutrient, but as an aggressive factor that must be destroyed. Upon repeated contact with it, the inflammatory process can begin even before it penetrates into the blood, for example, in the intestinal lumen. In this case, the patient will have diarrhea and pain throughout the abdomen, the body temperature will rise. The appearance of a rash will indicate the allergic nature of the disease and, together with the fact of drinking milk, a diagnosis of allergy to this food product will be established.

Diseases of the liver and gallbladder

The liver is an organ that secretes bile into the intestinal lumen, which is involved in the breakdown of milk fats. The gallbladder has the ability to accumulate and concentrate bile in order to allocate it to a certain phase of digestion and accelerate the breakdown of fats. When one of these organs becomes ill, their function suffers, and the digestion of milk is incomplete. With the penetration of undigested milk molecules into the blood, an allergization of the body with this product develops.

Children after the first year of life are more likely to develop subacute or chronic pain. Pain is better localized than more early age. Pain in umbilical region indicates acute enteritis of an allergic nature. At the same time, the nature of the pain is undulating, so the child's behavior will change. Periods of crying will be replaced by periods of rest. The mechanism of pain in this case is associated with peristaltic waves of the intestine. The inflamed and edematous intestinal mucosa contracts and stretches to the beat of peristaltic waves, which provokes the appearance of pain. With a slight pressure on the abdomen, no abnormalities are determined or a slight bloating is determined. The chronic course of milk allergy is dangerous because it is sluggish, and the mother will not always be able to guess about the incompatibility of this product with the child's body and will not exclude it from the diet. This can eventually lead to chronic pancreatitis, cholecystitis, and cholangitis, as well as intestinal enzyme deficiencies with the development of secondary celiac disease.

In adults, the symptoms of lesions of the gastrointestinal tract, as a rule, are less pronounced than in children and are reduced to pain in the stomach. The appearance of pain, in this case, is associated with an excessive accumulation of histamine in the blood during the phase of active clinical manifestations of allergy. Histamine is one of the substances that increase the acidity of gastric juice. At hyperacidity the mucus covering the stomach is corroded, and hydrochloric acid gradually destroys the stomach wall. This explains the concomitant gastric and duodenal ulcers, as well as the frequent feeling of heartburn in patients with a long-term allergy to milk. The nature of the pain is undulating. Against the background of an empty stomach, the pain intensifies, and when eating any food, it subsides, and then reappears. This phenomenon is associated with a decrease in the acidity of gastric juice when it is diluted with food.

Dyspnea
This symptom appears only with rapid and aggressive course allergic process and requires emergency medical care and follow-up in the intensive care unit.

There are several types of shortness of breath depending on the duration of the various phases of breathing:

• inspiratory;
• expiratory;
• mixed.

Inspiratory dyspnea develops when there is an obstruction to the passage of air into the lungs. With an allergy to milk, swollen vocal cords and less often greatly enlarged tonsils become this obstacle. With this type of shortness of breath, inhalation is difficult and lengthened, and exhalation is normal.

expiratory dyspnea develops when an allergic reaction triggers an asthma attack, the main manifestation of which is bronchospasm. As a result, air passes freely into the alveoli, and exits only when a certain effort is applied. With this type of shortness of breath, inhalation is free and short, and exhalation is long and labored. At the time of the attack, patients are forced to take a specific position in which their hands rest on a table, chair or window sill. In this position, the upper shoulder girdle, and in addition to the diaphragm, intercostal and scalene muscles are connected to the act of breathing, which additionally contract the chest and expel air out. Exhalation is accompanied by a specific whistle, audible at a distance.

Mixed dyspnea with an allergy to milk, as with any other allergy, it develops infrequently. In one case, its occurrence is associated with a rare Heiner's syndrome, in which, in response to the use of cow's milk, an allergic reaction develops, manifested by primary hemosiderosis of the lungs and their edema. In another case, the appearance of mixed shortness of breath is caused by acute heart failure. Due to the need for the heart to work hard with a decrease in blood pressure against the background of anaphylactic shock, myocardial infarction develops. With the development of myocardial infarction, stagnation of blood in the lungs occurs, gradually turning into pulmonary edema. With this type of breathing, the patient tends to take a vertical position. Breathing is frequent and shallow. On the face is an expression of panic and fear of death.

Cyanosis
Cyanosis is a skin manifestation of shortness of breath and lack of oxygen in the tissues. The color of the skin and mucous membranes changes to blue, gray and extremely serious condition to lilac purple. This is due to the fact that hemoglobin ( a protein found in red blood cells and responsible for gas exchange processes), binding carbon dioxide, takes on a dark color compared to the combination of hemoglobin with oxygen, which is scarlet red. With prolonged oxygen starvation, hemoglobin compounds with carbon dioxide begin to predominate in the blood, which stain the blood in a dark color.

Earlier and more intensely stained areas of thin skin and the most distant parts of the body from the body. Usually cyanosis begins with a slight cyanosis of the nasolabial triangle and fingers. With the progression of hypoxia ( lack of oxygen in tissues), blueness extends to the skin of the hands and forearms, the feet and lower legs are involved. Cyanosis of the trunk and in particular the chest is a poor prognostic sign.

Cough
This symptom is a reflex response of the body to irritation of the receptors of the larynx. In case of milk allergy, cough occurs when spreading angioedema on the larynx The respiratory epithelium lining the mucosa of this organ becomes excessively irritated. As a result, even normal respiratory flows or a slight change in the temperature or humidity of the inhaled air can cause coughing. The typical cough of laryngotracheitis is barking and harsh. It is characterized by a paroxysmal course with a long breath - a reprise.

Hoarseness of voice
Hoarseness develops for the same reason as a cough, but in this case, the swelling extends to the vocal cords. As a result, the ligaments swell, thicken and stop producing sound when air flows through them. As the glottis narrows, the voice disappears completely, and the air passes into the lungs with a characteristic quiet whistle.

Ear congestion
This symptom is not specific to milk allergy. Rather, it is associated with inflammatory phenomena in the cavity of the oropharynx and nasopharynx. With an allergic lesion of these departments, swelling of the Eustachian tubes develops - hollow canals that communicate the middle ear cavity with oral cavity. The main task of these channels is to maintain the same pressure in tympanic cavity and in the atmosphere. This mechanism ensures the safety of the tympanic membrane and maintains the function of hearing during sudden changes in pressure, which occur, for example, during a fall and climb, during explosions.

Autonomic disorders

Autonomic disorders are manifestations of compensatory mechanisms designed to restore balance, disturbed due to the allergic process. These mechanisms are activated mainly in life-threatening conditions, a striking example of which is anaphylactic shock. According to statistics, at least half of the deaths from anaphylaxis occurred after drinking milk.

With an allergy to milk, the following vegetative disorders develop:

• heartbeat;
• frequent breathing;
• dizziness, nausea and loss of balance;
• loss of consciousness.

heartbeat
This symptom is the body's response to a sharp decline blood pressure in the development of anaphylactic shock. It is felt by the patient as a tingling sensation in the chest Feeling like your heart is about to jump out. Palpitations are accompanied by a feeling of discomfort and incomprehensible anxiety. The heart rate increases to maintain blood pressure. Upon reaching a value of 140 beats per minute, a threshold occurs, after which an increase in heart rate does not make sense, since it is no longer effective. However, with a further drop in pressure, the heart rate continues to increase to 180, 200 and even 250 beats per minute. At this rate, the heart muscle is soon exhausted, and the normal rhythm is replaced by arrhythmia. In the absence of medical intervention at a given moment, arrhythmia entails a repeated drop in blood pressure to zero values. Blood circulation stops, and the brain, which is the most sensitive organ to hypoxia, dies after an average of 6 minutes.

Rapid breathing
Tachypnea or rapid breathing is also a consequence of a drop in blood pressure. On the one hand, it is due to the fact that the blood flow rate decreases, the tissues receive insufficient oxygen and report this to the brain. The latter increases the oxygen content in the blood by increasing the frequency respiratory movements. On the other hand, increased heart rate is associated with the patient's emotional response to sharp deterioration states.

Dizziness, nausea and loss of balance
The above symptoms develop as a result of oxygen starvation and a decrease in the functions of the cerebellum. This department brain is responsible for maintaining constant tone skeletal muscles, as well as their coordinated work. If its functioning is disturbed, a swagger of gait occurs, the accuracy of movements is lost, the handwriting becomes large and sweeping, there is a feeling of a sharply increased weight of one's own body. The adoption of a horizontal position improves the blood supply to the cerebellum and temporarily restores the patient's condition. However, with the further development of anaphylactic shock, the symptoms return and worsen.

Loss of consciousness
Syncope, otherwise known as loss of consciousness, develops when systolic blood pressure is less than 40 - 50 mm Hg. Art. It is caused by acute oxygen starvation of the nervous tissue of the brain. In the absence of oxygen, communication between the cortex and subcortical structures slows down. When the activity of these brain structures is completely disconnected, the patient falls into a coma. The duration of the patient's stay in this state determines how great the chances of complete rehabilitation after returning him to consciousness are.

Diagnosis of milk allergy

timely and accurate diagnosis milk allergy is extremely important in light of the complications it can entail. Besides, correct diagnosis involves proper treatment and adherence to the necessary lifestyle. Ultimately, all of the above measures lead to the maximum reduction of the negative effects of milk allergy and improve the overall quality of life.

Which doctor should I contact in case of problems?

An allergist is a specialist who is directly involved in the treatment of allergic diseases and in particular in the treatment of allergies caused by milk. Some symptoms and complications of the allergic process can be treated by other specialists. A dermatologist deals with the treatment of skin manifestations of allergies. A nephrologist treats chronic recurrent glomerulonephritis, which may be initiated by an allergic process. A rheumatologist will be helpful if it is necessary to differentiate allergies from one of the rheumatoid diseases, the skin manifestations of which are very similar to allergic ones. Pulmonologist treats bronchial asthma, which often occurs in patients with a long-term allergy to milk. A general practitioner treats allergies of mild to moderate severity.

At the doctor's appointment

Arriving at the doctor's appointment, the patient must fully concentrate on his illness and provide the specialist with all the information he needs. Sometimes the doctor has to ask the patient about some of the nuances that the latter would not want to talk about. Even in spite of this, the patient should answer unpleasant questions, since in some cases it is these answers that allow shedding light on the cause of the disease, even if they seem insignificant and irrelevant to the patient himself.

The most likely questions from the attending physician include:

• What manifestations of allergy does the patient complain about?
• What provokes the appearance of allergic conditions?
• How does the body come into contact with the allergen?
• After drinking how much milk do allergy symptoms appear?
• How long after drinking milk does an allergic reaction develop?
• How often does an allergic reaction occur on average?
• Do allergy symptoms go away on their own or do you have to resort to the use of medications?
• What medications does the patient use and how effective are they?
• At what age did the first signs of allergies appear?
• Are there allergies to substances other than milk?
• Does the patient have relatives suffering from allergic diseases?
• Is it possible that the allergic symptoms are caused by another substance and masked by the consumption of milk ( allergic to lead, present in the paint applied to the cup; allergy to milk packaging polyethylene; allergic to industrial preservatives, etc.)?
• What else does the patient eat, what hygiene products does he use in everyday life?
• Are there comorbid chronic diseases?
• What drugs does the patient take daily for concomitant diseases?

Patient examination
It is extremely successful if the patient goes to the allergist during the manifestation of an allergic reaction. In this case, the doctor has the opportunity to observe everything with his own eyes. existing symptoms and immediately conduct some examinations to clarify the allergic nature of the above manifestations. To do this, it is necessary to demonstrate to the doctor the places where the symptoms are present most abundantly. For example, a rash often appears on the intimate parts of the body. Despite its complex localization, the rash must be shown to the doctor, as it may be a symptom of another disease. For example, a rash on the buttocks and legs is one of the first signs meningococcal infection, which is much more dangerous than allergies. However, if there are no signs of allergy at the time of the visit to the doctor, then in no case should they be provoked by the intentional use of milk. Practice shows that after such a provocation, patients often do not have time to even reach the handset and call an ambulance, not to mention a visit to the doctor.

The presence of allergy symptoms at the time of examination definitely simplifies the diagnosis, but even in their absence, the doctor can assume the degree of their severity by indirect residual effects on the skin. In addition, it would be very helpful if the patient had photographs taken at the time of the recurrence of the allergic reaction. It is desirable that the photographs are clear, taken from various angles in good lighting.

Laboratory diagnostics

In addition to collecting anamnesis of the disease and examining the patient, a series of laboratory tests and provocative tests.

The following laboratory tests and clinical tests are used to confirm a diagnosis of milk allergy:

• immunogram;
• detection of lymphocytes and antibodies sensitized to milk proteins;
• scarification tests.

General blood analysis
This analysis can be called routine, but it often orients the attending physician towards the alleged group of diseases. With an allergic disease, the number of leukocytes will be moderately increased ( 12 - 15 * 10 ^9 ), and their largest fraction will be eosinophil cells ( more than 5%). The erythrocyte sedimentation rate will also be moderately increased to 15 - 25 mm/hour. These data are not specific to any allergen. Moreover, they can indicate with the same degree of probability the presence of helminths in the body.

General urine analysis
With proper urine sampling ( cleanly washed genitals and collection of a medium portion of urine in a sterile container) and good laboratory conditions this analysis can provide important information about the development of the allergic process. First of all, the level of protein will be increased, which indicates a general inflammatory process. The appearance of erythrocytes in the urine indicates the failure of the filtration function of the renal nephrons, which develops when inflammatory processes in this organ. Sometimes in the urine cylinders containing whole or dilapidated eosinophils are determined. Their presence indicates an allergic lesion. renal tissue and the development of glomerulonephritis as a complication of milk allergy.

Blood chemistry
In this laboratory study, the acute phase proteins of inflammation ( C-reactive protein, tumor necrosis factor, etc.). In addition, an increase in the number of immune complexes circulating in the blood will indicate the course of an allergic reaction.

Immunogram
The immunogram represents the ratio of different classes of immunoglobulins ( antibodies) circulating in the blood. An allergic reaction is characterized by the predominance of class E immunoglobulins, but sometimes there are allergic reactions that occur without their involvement.

Detection of lymphocytes and antibodies sensitized to milk proteins
This laboratory analysis is one of the most accurate basic analyzes that establishes a direct relationship between the consumption of milk and the development of an allergic process in a single individual. The accuracy of this analysis approaches 90%.

Scarifying tests
In addition to laboratory tests in allergology, the use of skin prick tests is often practiced. During their implementation, shallow scratches 0.5 - 1.0 cm long are made on the skin of the forearm or back, on which one drop of a different allergen is applied. Near each scratch, a brief designation of the allergen that was applied is inscribed with a pen. In the case of an allergy to milk, various proteins, fats and carbohydrates that are part of it are used separately as allergens. According to the latest data, milk contains about 25 antigens, each of which can provoke an allergic reaction. Across certain time an inflammatory shaft is formed around one or several scratches, which is larger in size than around the other scratches. This means that the body shows an allergic reaction to this component of milk.

Milk allergy treatment

Milk allergy treatment should be taken seriously. First of all, it is necessary to change the lifestyle in such a way as to completely exclude this allergen from the diet. Periodically, you should undergo preventive treatment courses aimed at reducing sensitization to milk. Finally, it is extremely important to help the patient correctly and in a timely manner in the midst of an allergic reaction, since this often determines his future fate.

Drug treatment in the acute period of allergy

Allergy medications

Drug group	Elimination of symptoms	Mechanism of action	Representatives	Mode of application
Antihistamines	Rash, swelling, itching, shortness of breath, cough, hoarseness,	Termination of histamine synthesis and acceleration of its destruction processes in tissues	Gel:	1 - 2 times a day in a thin layer, externally
			Fenistil
			Tablets:	25 mg 3-4 times a day inside
			Suprastin
			clemastine	1 mg 2 times a day orally
			Loratidine	10 mg once a day orally
			Syrup:	10 mg once a day orally
			Loratidine
			Injections:	0.1% - 2 ml 1 - 2 times a day intramuscularly
			clemastine
Systemic corticosteroids	Rash, swelling, itching, shortness of breath, nausea, dizziness, cough, hoarseness, nasal congestion, ear congestion, abdominal pain		Injections:	4 - 8 mg 1 - 2 times a day intramuscularly
			Dexamethasone
Topical corticosteroids	Rash, swelling, itching, shortness of breath	Powerful anti-inflammatory, anti-allergic and immunosuppressive action	Ointment:	0.1% thin layer 1-2 times a day externally
			Advantan
			Spray:	200 - 400 mcg ( 1 - 2 poufs) 2 times a day, inhalation
			Budesonide
Mast cell membrane stabilizers	Edema, rash, itching, shortness of breath, cough, hoarseness	Increasing the excitability threshold of mast cell membranes	Tablets:	1 mg 2 times a day, by mouth
			Ketotifen
Systemic adrenomimetics	Dizziness, loss of balance, loss of consciousness	Constriction of blood vessels and increased heart rate	Injections:	0.1% - 1 - 2 ml intravenously slowly! During resuscitation
			Adrenalin
Local adrenomimetics	Nasal congestion	Powerful vasoconstrictor action, edema reduction	Nasal drops:	0.1% 2 - 3 drops 4 times a day, intranasally
			Xylometazoline
Bronchodilators	Dyspnea	Constriction of the blood vessels of the bronchi and relaxation of the muscles of their wall	Spray:	1 - 2 puffs ( 0.1 - 0.2 mg) not more than 1 time in 4 - 6 hours, inhalation
			Salbutamol
			Injections:	2.4% - 5 ml in 5 - 10 ml physiological saline, intravenously slowly!
			Eufillin
Local anesthetics	Cough, itching	Increased excitability threshold of nerve receptors	Gel:	5% thin layer 1 - 2 times a day, externally; 0.3 g 3-4 times a day inside
			Drops:
			Benzocaine
Antispasmodics	Vomiting, abdominal pain	Relaxation of smooth muscles	Injections:	2% 1 - 2 ml 2 - 4 times a day intramuscularly
			Papaverine
			Drotaverine	1% 2 - 4 ml 1 - 3 times a day intramuscularly
Antidiarrheals	Diarrhea	Acceleration of reabsorption of fluid from the intestinal lumen	Capsules:	4 - 8 mg per day, by mouth
			loperamide
Eubiotics	Diarrhea	Recovery normal microflora with dysbacteriosis in chronic allergies	Capsules:	1 capsule 2 times a day, orally
			subtil
Enzyme preparations	Abdominal pain, diarrhea	Compensation of missing intestinal and pancreatic enzymes in chronic allergy sufferers	Tablets:	1 - 2 tablets 3 times a day, inside
			Festal
			Mezim	1 - 2 tablets 3 times a day, inside
Cholagogue	Abdominal pain, diarrhea	Elimination of bile deficiency in chronic allergy sufferers	Tablets:	1 tablet 2 - 3 times a day, inside
			Holiver

Hyposensitization of the body

The treatment of allergies by the method of desensitization and hyposensitization was introduced at the beginning of the twentieth century and has not changed significantly since then. There are two approaches. The first one is practically not used due to the high risk to the patient's life and dubious effectiveness. It consists in the fact that a concentrated solution of the same allergen is intravenously injected into the body of a patient with an allergy to milk or to a certain component of it. Contrary to expectations, an allergic reaction does not develop due to the fact that the immune system is paralyzed for some time by a large amount of foreign antigen. The disadvantage of this method is that an error associated with an incorrect calculation of the dose of the allergen can lead to the development of anaphylactic shock, from which it is not always possible to get the patient out even if the necessary medicines are available. In case of success, the effect, as a rule, is not very long and the body's sensitization to milk is restored.

The second approach is more practical and most commonly used. According to the author, this method is called "hyposensitization according to Bezredko". Its principle is to regularly intravenous administration a patient with an allergy to milk a small dose of a solution containing the allergen. The dose of the allergen should be such that, on the one hand, it provokes a weak response of the immune system, and on the other hand, it does not lead the patient into anaphylactic shock. As treatment progresses, the dose is gradually increased until the patient can consume the pure product. This method is more often used for allergies to substances, contact with which cannot be limited without compromising the quality of life of the patient ( dust, gasoline, etc.). Milk is a product that can be painlessly removed from the diet and replaced by other products with a similar composition. Therefore, this method is rarely used, despite the fact that it shows good results. With an allergy to one component of milk, a complete cure occurs in 90% of patients. With an allergy to two or more components, the effectiveness is reduced to 60%.

Lifestyle

Since milk is not a vital food product, it can be easily replaced with other products with a similar chemical composition that won't cause allergies. Therefore, the patient is required to comply with the only rule - the complete exclusion of milk and dairy products from the diet.

It is important to remember that even after many years of preventive treatment, when, it would seem, the allergy is completely cured, contact with milk should not be allowed. The first contact after a long break will not cause a violent allergic reaction due to the fact that over time the titer of antibodies to milk will decrease many times over. However, after a few days, the immune system will develop new antibodies, and upon repeated contact with milk, the allergic reaction will be much more pronounced.

It is also recommended, along with the allergen, to exclude from the diet foods rich in histamine and those that have an increased histamine-releasing effect. These foods include strawberries, citrus fruits, legumes, sauerkraut, nuts and coffee.

Prevention of milk allergy

In some cases, milk allergy can be prevented. In this case we are talking on maternal behavior during pregnancy and lactation and its impact on fetal development. In the case when an allergy to milk has already manifested itself, there is nothing left but to minimize the contact of the body with this substance.

What do we have to do?

• During pregnancy, drink milk no more than 2 times a week, 1 glass per dose;
• Exclude from the diet foods containing a large amount of histamine;
• Instead of milk, use fermented milk products;
• Exclude industrial canning products from the diet;
• Introduce complementary foods later than expected if the family has relatives with allergic diseases;
• Periodically take preventive courses of treatment for allergies;
• Provide yourself and close relatives with a first aid kit for allergies;
• Restore the lack of substances present in milk by taking additional vitamins and microelements;
• Receive antihelminthic treatment once or twice a year.

What should be avoided?

• Late attachment of the newborn to the breast;
• Failure of the hypoallergenic diet in the mother;
• Early artificial feeding;
• stressful situations;
• Prolonged course of intestinal disorders and dysbacteriosis;
• Aggressive environmental factors;
• Uncontrolled intake immunostimulants.